PAST TRAUMATIC LIFE EVENTS AND POSTPARTUM PTSD

Abstract

Postpartum post-traumatic stress disorder (PP-PTSD) can be conceptualised both as the fi rst-time onset disorder related solely to childbirth in the absence of prior PTSD symptoms or any predisposing factors as well as a pre-existing PTSD after previous traumatic events that is reactivated by childbirth. Accordingly, convincing evidence indicates that past traumatic experience is a signifi cant risk factor for developing PP-PTSD. The aim of this study was to investigate the association of postpartum posttraumatic stress disorder (PP-PTSD) symptoms and subjective rates of traumatic birth experience with past traumatic life events, namely physical and sexual assault, child abuse, and the cumulative traumatic experience. Furthermore, we investigated the effects of previous traumatic birth experience on subsequent childbirth and risk of PP-PTSD. A sample of Russian women (n= ) who gave birth within the previous  months, fi lled in a web-based survey, where they reported demographic and obstetric characteristics, past traumatic experiences, evaluated their birth experience (-not traumatic, -extremely traumatic) and completed the Edinburgh Postnatal Depression Scale (EPDS) and the City Birth Trauma Scale (CBiTS). We found that PP-PTSD symptoms were higher among women who previously experienced physical (F=., p<.) and sexual (F=.,p<.) assault and child abuse (F=.,p<.), with only associations with child abuse (F=.,p<.) remaining signifi cant for subjective rates of traumatic birth experience. After adjustment for covariates the cumulative traumatic experiences were signifi cantly associated with both PP-PTSD symptoms (B=.,p<.) and the subjective rates of traumatic birth experience (B=.,p<.). PP-PTSD symptoms were lowest for those who had already given birth previously and that experience had not been traumatic; they were, on average, more than . points higher for those who gave birth for the fi rst time in the present study, and, fi nally, the highest scores were among the participants whose previous birth experience was also traumatic (F=., p<.). Trauma awareness training for midwives, obstetricians and other caregivers working with women during perinatal period is essential and trauma-informed practices during childbirth are warranted for prevention of PP-PTSD.